Size Of Ln3 Research Articles

329. PREDICTION OF MEDIASTINAL LYMPH NODE METASTASIS IN SIEWERT TYPE I/II ESOPHAGOGASTRIC JUNCTION CANCER WITH ESOPHAGEAL INVASION

Abstract Background Mediastinal lymph node dissection (LND) is a critical factor to decide the surgical strategy for Esophagogastric junction (EGJ) cancers. As a result of a prospective multicenter study in Japan, surgical algorithm including the extent of LND for EGJ cancers has recently been proposed according to the length of esophageal invasion. However, preoperative measure predicting upper mediastinal LN metastasis is still lacking, and the oncologic efficacy of mediastinal LND remain unknown. Methods The aim of this study was to identify preoperative factors predicting mediastinal LN metastasis, and we hypothesized that preoperative CT image would be of utility. Patients who underwent surgical treatment for Siewert Type I/II EGJ cancer with esophageal invasion with curative intent between 2000 and 2022 at the Tokai University Hospital were retrospectively reviewed. Results A total of 103 patients were enrolled. Among them, 55, 74, and 74 patients underwent upper, middle, and lower mediastinal LND, respectively. Upper/middle/lower mediastinal LN metastasis was observed in 14/13/23 of those patients, respectively, with lower thoracic paraesophageal LNs (29%), middle thoracic paraesophageal LNs (18%), and right recurrent nerve LNs (16%) being the three most common metastatic sites. Estimated invasion depth of the primary lesion≧cT3 (p≦0.007), tumor size≧4cm (p≦0.002), esophageal invasion length≧4cm (p≦0.007) and minor axis of the LN≧5mm by preoperative CT image (p<0.001) were significant preoperative factors related to mediastinal LN metastasis. Conclusion Clinical T factor, tumor size, the size of mediastinal LN by CT image, as well as esophageal invasion length, were important preoperative factors to predict mediastinal LN metastasis, and those factors should be taken into consideration to decide the surgical strategy for EGJ cancers with esophageal invasion. Survival impact of mediastinal LND still remain unclear, and further accumulation of cases and prospective studies are awaited.

Investigating the level of vitamin D receptor gene expression in two tumoral and healthy breast tissues in breast cancer patients and its association with prognostic factors.

Breast cancer is one of the most common cancers known among women. This study aimed to investigate the level of vitamin D receptor gene expression in two tumoral and healthy breast tissues in breast cancer patients and its association with prognostic factors. This descriptive cross-sectional study was conducted in 2022 on 50 patients with high suspicion of breast cancer who were candidates for mastectomy and lumpectomy in a learning hospital. From the patients, two tissue samples were prepared, and there was a total of 100 samples. The samples were subjected to H/E staining and evaluated by a pathologist. The presence or absence of malignancy in each sample was confirmed by two pathologists, and HER2/ER/PR indices were determined. Descriptive and analytical statistical methods and SPSS version 22 software were used. The average age of the patients was 51.60 ± 11.22 years old, and the average tumor size was 3.17 ± 1.28. Most tumors were grade 2 (48%). The expression of HER2, ER, and PR was positive in 24, 64, and 54%, respectively. The largest number of cases were in stage 2A. The expression level of vitamin D receptor (VDR) gene in healthy tissue (2.08 ± 1.01) was higher than tumoral tissue (0.25 ± 1.38) (P = 0.001). In tumoral and healthy tissue, VDR expression was not significant according to tumor grade, HER2, ER, PR, LVI, LN, disease stage, age, and tumor size. The expression level of VDR in healthy tissue was significantly higher than tumoral tissue. However, there was no significant relationship between VDR and tumor grade, HER2, ER, PR, LVI, LN, disease stage, age, and tumor size.

Oxygen Migration Pathways in Layered LnBaCo2O6-δ (Ln = La - Y) Perovskites.

Layered LnBaCo2O6-δ perovskites are important mixed ionic-electronic conductors, exhibiting outstanding catalytic properties for the oxygen evolution/reduction reaction. These phases exhibit considerable structural complexity, in particular, near room temperature, where a number of oxygen vacancy ordered superstructures are found. This study uses bond valence site energy calculations to demonstrate the key underlying structural features that favor facile ionic migration. BVSE calculations show that the 1D vacancy ordering for Ln = Sm-Tb could be beneficial at low temperatures as new pathways with reduced barriers emerge. By contrast, the 2D vacancy ordering for Ln = Dy and Y is not beneficial for ionic transport with the basic layered parent material having lower migration barriers. Overall, the key criterion for low migration barriers is an expanded ab plane, supported by Ba, coupled to a small Ln size. Hence, Ln = Y should be the best composition, but this is stymied by the low temperature 2D vacancy ordering and moderate temperature stability. The evolution of the oxygen cycling capability of these materials is also reported.

Is there an association between lymph node size and hyperprogression in immunotherapy-treated patients?

Hyperprogressive disease (HPD) can be described as an accelerated increase in the growth rate of tumors combined with rapid clinical deterioration observed in a subset of cancer patients undergoing immunotherapy, specifically with immune checkpoint inhibitors (ICIs). The reported incidence of HPD ranges from 5.9% to 43.1% in patients receiving ICIs. In this context, identifying reliable predictive risk factors for HPD is crucial as it may allow for earlier intervention and ultimately improve patient outcomes. This study retrospectively analyzed ten metastatic renal cell carcinoma (mRCC) patients. The identification of HPD was based on the diagnostic criteria proposed by Ferrara R et al. This study aimed to investigate whether there is an association between LN size and HPD using a cutoff value of 3 cm for LN size. Given the limited sample size, Fisher's exact test was used to test this association. We conducted a Kaplan-Meier (KM) analysis to estimate the median overall survival (OS) of patients with HPD and compared it to those without HPD. Three patients (30%) developed HPD, while seven (70%) did not. Fisher's exact test revealed a statistically significant association between the HPD and LN size ≥ 3 cm (p=0.008). In the HPD group, the median OS was significantly shorter, with a median OS of 3 months, whereas in the non-HPD group, the median OS was not reached (P =0.001). The present study found a significant association between LN size ≥ 3 cm in the pretreatment period and HPD development.

The Influence of Profitability, Liquidity, Leverage and Company Size on Stock Returns

The purpose of this study is to determine the effect of profitability, liquidity, leverage and size of the company to stock return on manufacturing companies in Indonesian Stock Exchange (Idx). In this study the independent variables used are profitability measured by using Return On Assets (ROA), liquidity measured by using Current Ratio, leverage is measured by using Debt to Equity Ratio (DER) and firm size measured by using Ln (Size). Stock Return in this research is used as dependent variable. This study was conducted on manufactured companies listed on manufacturing companies in Indonesian Stock Exchange (Idx) 2017-2019. Using purposive sampling technique, resulting 71 companies as a research sample. Data analysis techniques used are multiple linear regression analysis. Based on the results of the research shows that profitability, liquidity and leverage do not has a significant effect on stock return, while firm size have a significant effect on stock return.

KINERJA KEUANGAN, UKURAN PERUSAHAAN DAN EARNING PER SHARE : BUKTI PERUSAHAAN RITEL

The purpose of this study is to determine and analyze the effect of Total Asset Turnover, Debt to Equity Ratio, Current Ratio and LN SIZE on Earnings per Share of retail companies listed on the Indonesia Stock Exchange for the 2017-2020 period. The research method was carried out using Purpose Sampling with a description method and data collection using the documentation method and the Data Analysis Method using Multiple Linear Regression Analysis. From the results of the research that has been done, partially the Total Asset Turnover, Debt to Equity Ratio, Current Ratio and LN SIZE variables have a significant effect on Earning per Share

Solvothermal synthesis of lanthanide-functionalized graphene oxide nanocomposites

We propose a facile approach to the preparation of graphene oxide (GO) composites with lanthanide (Ln) oxide/hydroxide nanoparticles (Ln = La, Eu, Gd, Tb) under relatively mild conditions by two different procedures of solvothermal synthesis. The mechanism of GO-Ln nanocomposite formation is thought to involve the initial coordination of Ln3+ ions to the oxygen-containing groups of GO as nucleation sites, followed by f Ln2O3 and Ln(OH)3 nanoparticle growth. The nanocomposites obtained preserve the intrinsic planar honeycomb-like structures of graphene as proven by the typical G and D bands in the Raman spectra. Fourier-transform infrared and X-ray photoelectron spectroscopy confirm the interaction between oxygen-containing groups of GO and Ln ions. The size and distribution of Ln oxide/hydroxide nanoparticles on GO sheets, estimated from scanning and transmission electron microscopy images, vary broadly for the different lanthanides. The size can span from sub-nm dimensions for Eu oxide to more than 10 μm for Eu hydroxide nanoparticles. The most homogeneous distribution of Ln oxide/hydroxide nanoparticles was found in La-containing composites. Thermogravimetric analysis demonstrated that all the GO-Ln nanocomposites are thermally less stable, by up to 30 °C than pristine GO.

Neoadjuvant chemotherapy for locally advanced head and neck squamous cell carcinoma - Is it still relevant? A practice pattern survey among oncologists of India.

Concurrent chemotherapy is the recommended treatment for locally advanced head and neck (H&N) squamous cell carcinoma, and neoadjuvant chemotherapy (NACT) is debated with a few special indications. NACT for advanced head and neck cancer has been studied in clinical trials for more than 2 decades without clear demonstration of the benefit for loco regional tumor control or overall patient survival. Its benefit remains controversial in the absence of clear evidence to define its role. However, there is widespread use of NACT among oncologists. We conducted an online survey to find out the frequency, pattern, prevalence, and aims for use of NACT in locally advanced head and neck cancers among radiation, medical, and surgical oncologists. Oncologists across India who expressed interest to participate in our survey were asked to complete a short online questionnaire designed to identify the current practice pattern of NACT in head and neck cancer. A mobile app-based questionnaire was sent to 200 oncologists across the country to assess the pattern of NACT use and to solicit their most frequent therapy approach for patients with locoregionally advanced head and neck cancer. One hundred and fifty (150) oncologists completed and returned the survey (75%), and 130 were finalized (94 radiation oncologists, 19 medical oncologists, and 17 surgical oncologists). The single most common treatment approach reported for patients with locoregionally advanced H&N cancer was that of sequential chemoradiation (61%), specifically NACT with the TPF regimen (78.5%), followed by radiation therapy. The primary objectives cited by respondents for the use of NACT included the desire to buy time for definitive treatment (20%) and to achieve R0 resection (19.2%). Use of NACT in most patients was more preferred by medical oncologists (21.1%) and radiation oncologists (19.1%) than surgical oncologists (11.8%). Thus, there is not much difference in perception in practice of NACT in radiation, medical, and surgical oncologists. A minimum of two cycles of NACT was preferred by more than half of the doctors (55.4%) with 59.6% radiation oncologists using it before further assessment. Although level I evidence for inferior outcomes with NACT as compared to concurrent chemoradiation therapy is there, the use of NACT is quite common among various oncologists in the country because of reasons such as buying time for definitive treatment, achieving R0 resection, better outcome and survival, partial response, better tolerability, better distant control, LN size regression, down-staging of primary tumor, selection of chemosensitive patients, reducing the volume of the radiation field, and better tolerability of subsequent Chemoradiation (CTRT) intensity of subsequent chemoradiation therapy.

Relapsed/Refractory Chronic Lymphocytic Leukemia Patients Treated with Fixed Duration Venetoclax-Rituximab: Assessment of Response with Ultrasound, and Relationship with Minimal Residual Disease

A fixed duration of venetoclax-rituximab (VenR) resulted in a significant benefit of both PFS and in the attainment of an undetectable minimal residual disease (uMRD) compared with bendamustine-rituximab in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) patients. The 2018 International Workshop on CLL guidelines, outside the context of clinical trials, suggested ultrasonography (US) as a possible imaging technique to evaluate visceral involvement, and palpation to evaluate superficial lymph nodes (SupLNs). In this real-life study we prospectively enrolled N = 22 patients. Patients were assessed by US, to determine nodal and splenic response in R/R CLL patients treated with a fixed duration VenR. We found an overall response rate, complete remission, partial remission, and stable disease, of 95.4%, 68%, 27.3%, and 4.5%, respectively. Responses were also correlated with risk categories. The time to response, and the time to clearance of the disease in the spleen, in abdominal LN (AbdLNs), and in SupLNs were discussed. Responses were independent from LN size. The correlation between response rate with MRD were also investigated. US allowed to detect a substantial CR rate correlated with uMRD.

Initial Returns Determinants with the Underwriter’s Reputation as a Moderating Factor

Main purpose- The main purpose of this study is to find out the factors that affect the initial return. Accounting information and non-accounting information are components that determine the initial return that needs to be considered.Method - The population used is all companies that conducted initial public offerings (IPOs) on the Indonesia Stock Exchange (IDX) in the 2016-2020 period. In this study, the sampling technique used was non-probability sampling with a saturated sample technique of 135 companies. This study used multiple linear regression analysis to test its hypothesis.Main Findings-The results of the hypothesis testing concluded that the return on assets has a positive and significant effect on the initial return. The underwriter's reputation was able to moderate the relationship between return on assets and initial returns. The debt-to-equity ratio has a significant negative effect on the initial return. The underwriter's reputation was able to moderate the relationship between the debt-to-equity ratio and initial return. The current ratio positively and not significantly affect the initial return on investment. The underwriter's reputation was able to moderate the relationship between the current ratio and the initial return. The company's size positively and significantly affects the initial return. The underwriter's reputation was able to moderate the relationship of company size to initial return. Earnings per share have a negative and significant effect on initial returns. The underwriter's reputation cannot be moderated on earnings per share versus initial return. The price-earnings ratio has a positive but not significant effect on the initial return.Theory and Practical Implications - The findings of this study have implications for initial public offerings (IPOs) in the primary market, as well as parties who will conduct further research on factors that affect initial returns, such as issuers who will go public. These investors will make decisions about investing in companies with high underpricing rates. The results of this study are expected to contribute to the company or issuer, and also to investors who will invest that the underwriter's reputation can moderate the influence of ROA, DER, SIZE, and EPS on the initial return.Novelty- The novelty in this study is to use the underwriter reputation variable as a moderation variable that will strengthen the influence of the ROA, DER, CR, Ln Size, EPS, and PER variables on the initial return, whereas previous studies did not use it as a moderation variable.

Survival Outcomes and Factors Affecting Survival in Resectable Locally Advanced Oral Squamous Cell Carcinoma.

Management of locally advanced OSCC include primary surgery followed by adjuvant radiotherapy or chemo radiation, concurrent chemo radiation, induction chemotherapy followed by surgery or non surgical methods. In resectable disease the role of induction chemotherapy is questionable and surgery remains the first choice. In this study we aimed at evaluating the survival and factors effecting survival in locally advanced oral cancer. retrospective review of patient records was made. Kaplan Meir method was used to evaluate OS and DFS rate and log rank test was used to compare the survival amongst groups. Cox regression analysis (univariate and multivariate) was used to evaluate the hazard ratio to find out the possible factors influencing risk of death and disease. The 3year OS of the entire cohort was 56.80% and 3year DFS was 52.4%. ECS, surgical margin, PNI, LVI and LN size were independent risk factors for poor overall and disease free survival. We identified ECS, positive margin, LVI, PNI and LN size as independent risk factors effecting survival. These factors justify the use of adjuvant radiotherapy or chemo radiation according to the already available guidelines.

Prognostic significance of inflammatory markers LMR, PLR, MPV, FIB in intermediate-and high-risk papillary thyroid carcinoma.

Lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) and fibrinogen (FIB) have been identified as predictive biomarkers in several malignancies. The aim of this study was to explore the association between inflammatory index with clinicopathologic features as well as recurrence risk in intermediate-to high-risk papillary thyroid carcinoma (PTC). Retrospective evaluation of 212 patients diagnosed with intermediate-to high-risk PTC who underwent surgery at China-Japan Union Hospital between 2015 and 2016. Logistic regression and receiver operating curves (ROC) were used to explore possible risk factors. LMR was predictive of capsular invasion (AUC=0.595, P=0.017), FIB was predictive of lymph node metastasis (LN) (AUC=0.714, P=0.002), MPV was predictive of largest LN size ≥1cm (AUC=0.639, P=0.002), PLR and MPV were predictive of recurrence (AUC=0.616, P=0.032; AUC=0.626, P=0.020). In addition, FIB ≤ 2.6 (OR=6.440, 95%CI:1.777-23.336, P=0.005) and capsular invasion (OR=3.773, 95%CI:1.171-12.159, P=0.026) were identified as independent risk factors for lymph node metastasis by multivariate analysis. In addition, LN metastasis (P=0.048), largest LN size ≥ 1cm (P=0.032), MPV > 9.4 (P=0.046), and PLR ≤ 128.1 (P=0.032) were significantly related with recurrence. Further multivariate regression analysis revealed that PLR ≤ 128.1 was a potentially independent risk factor for recurrence. Specifically, the risk of recurrence was 2.951 times higher in patients with a PLR ≤ 128.1 compared with patients with a PLR > 128.1 (OR=2.951, 95% CI:1.238-7.037, P=0.015). In intermediate-to high-risk PTC, LMR, PLR, MPV, and FIB could predict clinicopathologic features and recurrence, with lower PLR being the potential risk factors for recurrence.

Is total thyroidectomy with bilateral central neck dissection the only surgery for papillary thyroid carcinoma patients with clinically involved central nodes?

BackgroundIn clinical practice, we often observed that patients who underwent total thyroidectomy due to clinically involved nodal disease (cN1a) actually had less extensive CLNM on final pathology. This study investigates whether total thyroidectomy and therapeutic bilateral CND are necessary for all PTC patients with cN1a.MethodsThis study retrospectively reviewed 899 PTC patients who underwent total thyroidectomy with bilateral CND from January 2012 to June 2017. The patients were divided into two groups according to pre-operative central lymph node (CLN) status: cN0, no suspicious CLNM; cN1a, suspicious CLNM. We compared the clinicopathological features of these two groups.ResultsThere was no significant difference in recurrence between cN0 and cN1a groups after a mean follow-up time of 59.1 months. Unilateral cN1a was related to the largest central LN size ≥ 2 mm (OR = 3.67, p < 0.001) and number of CLNM > 5(OR = 2.24, p = 0.006). On the other hand, unilateral cN1a was not associated with an increased risk of contralateral lobe involvement (OR = 1.35, p = 0.364) and contralateral CLNM (OR = 1.31, p = 0.359). Among 106 unilateral cN1a patients, 33 (31.1%) were found to be pN0 or had ≤ 5 metastatic CLNs with the largest node smaller than 2 mm.ConclusionsMost cN1a patients were in an intermediate risk group for recurrence and required total thyroidectomy. However, lobectomy with CND should have performed in approximately 30% of the cN1a patients. Pre-operative clinical examination, meticulous radiologic evaluation, and intra-operative frozen sections to check the nodal status are prerequisites for this approach.

EA8185: Phase 2 study of bladder-sparing chemoradiation (chemoRT) with durvalumab in clinical stage III, node-positive urothelial carcinoma (INSPIRE), an ECOG-ACRIN/NRG collaboration.

TPS4617 Background: Patients [pts] withlymph node positive (LN+), non-metastatic bladder cancer (BC) have a better prognosis than those with metastatic (M1) disease. However, this population is under-represented in advanced bladder trials and ineligible for bladder-sparing trials. Therefore, there have been no larger prospective trials establishing the standard of care in LN+ BC. Given the promise of immunotherapy in advanced BC and potential synergy between immunotherapy and radiation, INSPIRE was designed to determine the role of concurrent and adjuvant durvalumab (durva) in this patient population when treated with induction chemotherapy (IC) followed by concurrent chemoRT. Methods: This is a randomized phase II study that is enrolling BC pts with stage III [N1-3 M0], pure or mixed urothelial cancer. Pts must have received ≥3 cycles of IC [either before or after registration, prior to randomization] without progression. LN+ is defined as radiologically LN ≥1.0 cm in short axis, with or without biopsy prior to IC. As long as pts do not progress on induction chemotherapy, they will be randomized to chemoRT+/- durva using 5 stratification factors (Simon Pocock minimization method) a) IC prior vs. post registration b) cisplatin vs non-cisplatin regimen during RT c) LN size d) response to IC e) extent of TURBT. Pts on the chemoRT+durva arm will get chemotherapy per physician choice + IMRT + 3 x doses of Q3wk durva for 6.5-8 wks, whereas those on the control arm will get chemoRT alone. The primary end point is clinical complete response [CR], defined as no radiologically measurable disease in the LNs and negative cystoscopy and bladder biopsy 8-10 weeks post-chemoRT +/- durva. Pts on the chemoRT + durva arm who have a CR or clinical benefit ( &gt; T0 and ≤T2 in bladder per cystoscopy, biopsy + CR/PR/SD in LN by imaging) will get adjuvant Q4wk durva for 9 doses, while those on the chemoRT arm will undergo observation. Secondary end points include OS, PFS, bladder-intact event-free survival, rate of toxicity and salvage cystectomy. This study is designed to detect an improvement of 25% in clinical CR between both arms (37.5% to 62.5%). A total accrual of 114 pts (in order to enroll 92 evaluable pts) will provide 81% power to detect this difference using a Fisher’s exact test (assuming 10% drop out + anticipating that 20% chemotherapy-naïve pts will progress post IC). We are banking blood and primary tumor tissue pre- and post-chemoRT in both groups. The study was activated in August 2020 and accrual is ongoing. We expanded eligibility to include N3 in 9/2021. INSPIRE is the first prospective study designed for only LN+ BC and will define both short-term and long-term outcomes for bladder sparing in this patient population and has the potential to define a new treatment strategy for stage III BC. Clinical trial information: NCT04216290.

Predictors of Extracapsular Spread in T1/T2 Oral Squamous Cell Carcinoma: A retrospective study

IntroductionIn the N0 neck the incidence of ECS might range from 13 to 60%. In this retrospective study we intended at evaluating the primary tumor and nodal characteristics that might influence the presence of ECS in early stage OSCC. MethodsThe predictor variables were tumor and nodal features and the incidence of ENE was the outcome. Univariate and multivariate regression models along with ROC curve and Youden's J statistics was used for analysis. A p value < 0.05 was considered statistically significant. ResultsThe cut off value for DOI was 6.5 mm and LN size was 12.5 mm with overall accuracy of 80.15% and 84.93% respectively. Primary tumor features and LN size was significantly associated with ENE. DiscussionOral tongue tumors and PNI are independent risk factors for ENE. An elective neck dissection remains the standard of care from both diagnostic and therapeutic viewpoints.

Open-Shell Early Lanthanide Terminal Imides.

Group 3- and 4f-element organometallic chemistry and reactivity are decisively driven by the rare-earth-metal/lanthanide (Ln) ion size and associated electronegativity/ionicity/Lewis acidity criteria. For these reasons, the synthesis of terminal "unsupported" imides [Ln═NR] of the smaller, closed-shell Sc(III), Lu(III), Y(III), and increasingly covalent Ce(IV) has involved distinct reaction protocols while derivatives of the "early" large Ln(III) have remained elusive. Herein, we report such terminal imides of open-shell lanthanide cations Ce(III), Nd(III), and Sm(III) according to a new reaction protocol. Lewis-acid-stabilized methylidene complexes [TptBu,MeLn(μ3-CH2){(μ2-Me)MMe2}2] (Ln = Ce, Nd, Sm; M = Al, Ga) react with 2,6-diisopropylaniline (H2NAriPr) via methane elimination. The formation of arylimide complexes is governed by the Ln(III) size, the Lewis acidity of the group 13 metal alkyl, steric factors, the presence of a donor solvent, and the sterics and acidity (pKa) of the aromatic amine. Crucially, terminal arylimides [TptBu,MeLn(═NAriPr)(THF)2] (Ln = Ce, Nd, Sm) are formed only for M = Ga, and for M = Al, the Lewis-acid-stabilized imides [TptBu,MeLn(NAriPr)(AlMe3)] (Ln = Ce, Nd, Sm) are persistent. In stark contrast, the [GaMe3]-stabilized imide [TptBu,MeLn(NAriPr)(GaMe3)] (Ln = Nd, Sm) is reversibly formed in noncoordinating solvents.

Hierarchical Assembly of Coordination Macromolecules with Atypical Geometries: Gd44Co28 Crown and Gd95Co60 Cage

AbstractThe discovered giant clusters are always highly symmetric owing to the spontaneous assembly of one or two basic units. Herein we report the Gd44Co28 crown and Gd95Co60 cage, formulated as [Gd44Co28(IDA)20 (OH)72(CO3)12(OAc)28(H2O)64]⋅(ClO4)24 and [Na4Gd95 Co60(IDA)40(OH)150(CO3)40(OAc)58(H2O)164] ⋅ (ClO4)41 (H2IDA=iminodiacetic acid), respectively, by providing a library containing multiple low‐nuclearity units. The heart‐like units and crown‐like tetramer found in both compounds indicate unprecedented assembly levels, leading to an atypical geometry characteristic compared to the giant clusters directly assembled by regular units. These two clusters not only significantly increase the size of Ln−Co clusters but also exhibit the enhanced magnetic entropy change at ultra‐low temperatures. This work provided an effective way to fabricate cluster compounds with giant size and geometry complexity simultaneously.

Hierarchical Assembly of Coordination Macromolecules with Atypical Geometries: Gd44 Co28 Crown and Gd95 Co60 Cage.

The discovered giant clusters are always highly symmetric owing to the spontaneous assembly of one or two basic units. Herein we report the Gd44 Co28 crown and Gd95 Co60 cage, formulated as [Gd44 Co28 (IDA)20 (OH)72 (CO3 )12 (OAc)28 (H2 O)64 ]⋅(ClO4 )24 and [Na4 Gd95 Co60 (IDA)40 (OH)150 (CO3 )40 (OAc)58 (H2 O)164 ] ⋅ (ClO4 )41 (H2 IDA=iminodiacetic acid), respectively, by providing a library containing multiple low-nuclearity units. The heart-like units and crown-like tetramer found in both compounds indicate unprecedented assembly levels, leading to an atypical geometry characteristic compared to the giant clusters directly assembled by regular units. These two clusters not only significantly increase the size of Ln-Co clusters but also exhibit the enhanced magnetic entropy change at ultra-low temperatures. This work provided an effective way to fabricate cluster compounds with giant size and geometry complexity simultaneously.

EA8185: Phase 2 study of bladder-sparing chemoradiation (chemoRT) with durvalumab in clinical stage III, node positive urothelial carcinoma (INSPIRE), an ECOG-ACRIN/NRG collaboration.

TPS594 Background: Patients [pts] withlymph node positive (LN+), non-metastatic bladder cancer (BC) have a better prognosis than those with metastatic (M1) disease. However, this population is under-represented in advanced bladder trials and ineligible for bladder-sparing trials. Therefore, there have been no larger prospective trials establishing the standard of care in LN+ BC. Given the promise of immunotherapy in advanced BC and potential synergy between immunotherapy and radiation, INSPIRE was designed to determine the role of concurrent and adjuvant durvalumab (durva) in this patient population when treated with induction chemotherapy (IC) followed by concurrent chemoRT. Methods: This is a randomized phase II study that is enrolling BC pts with stage III [N1-3 M0], pure or mixed urothelial cancer. Pts must have received ≥3 cycles of IC [either before or after registration, prior to randomization] without progression. LN+ is defined as radiologically LN ≥1.0 cm in short axis, with or without biopsy prior to IC. As long as pts do not progress on induction chemotherapy, they will be randomized to chemoRT+/- durva using 5 stratification factors (Simon Pocock minimization method) a) IC prior vs. post registration b) cisplatin vs non-cisplatin regimen during RT c) LN size d) response to IC e) extent of TURBT. Pts on the chemoRT+durva arm will get chemotherapy per physician choice + IMRT + 3 x doses of Q3wk durva for 6.5-8 wks, whereas those on the control arm will get chemoRT alone. The primary end point is clinical complete response [CR], defined as no radiologically measurable disease in the LNs and negative cystoscopy and bladder biopsy 8-10 weeks post-chemoRT +/- durva. Pts on the chemoRT + durva arm who have a CR or clinical benefit (&gt;T0 and ≤T2 in bladder per cystoscopy, biopsy + CR/PR/SD in LN by imaging) will get adjuvant Q4wk durva for 9 doses, while those on the chemoRT arm will undergo observation. Secondary end points include OS, PFS, bladder-intact event-free survival, rate of toxicity and salvage cystectomy. This study is designed to detect an absolute improvement of 25% in clinical CR between both arms (37.5% to 62.5%). The accrual goal is 114, assuming 10% drop out + anticipating that 20% chemotherapy-naïve pts will progress post IC, and 92 evaluable pts that will provide 81% power to detect this difference using a Fisher’s exact test. We are banking blood and primary tumor tissue pre- and post-chemoRT in both groups. The study was activated in August 2020 and accrual is ongoing. We expanded eligibility to include N3 in 9/2021. INSPIRE is the first prospective study designed for only LN+ BC and will define both short-term and long-term outcomes for bladder sparing in this patient population and has the potential to define a new treatment strategy for stage III BC. Clinical trial information: NCT04216290.

Incidence and prognostic significance of extranodal extension in isolated nodal recurrence of oral squamous cell carcinoma

BackgroundExtranodal extension (ENE) is a crucial prognostic factor of oral squamous cell carcinoma (OSCC). However, the role of ENE in regional recurrence (rENE) remains unclear. The purpose of our study is to assess the salvage outcome according to the presence of rENE in oral cancer patients with isolated nodal recurrence. MethodsOral cancer patients diagnosed with isolated nodal recurrence at the National Taiwan University Hospital between January 2010 and December 2015 were reviewed. All patients were classified into two groups: with and without rENE. The treatment included salvage neck dissection (ND) ± metronomic chemotherapy, salvage ND and radiation (RT)/concurrent chemoradiation (CCRT), Salvage RT/CCRT alone, metronomic chemotherapy, or supportive care. ResultsWe analyzed 198 patients, 156 with rENE and 42 without rENE. rENE presented more frequently in patients with initial ENE+ (OR = 3.17, p = 0.04), prior RT+ (OR = 2.96, p = 0.02), initial N2/N3 (OR = 2.76, p = 0.01), and recurrent LN size >1.5 cm (OR = 2.33, p = 0.03). The extent of rENE were also significantly different in these patients. The 2-year disease-free survival for patients with and without rENE were 15.7% and 31.7%, respectively (p = 0.002). The 2-year overall survival for patients with and without rENE were 19.6% and 43.9%, respectively (p = 0.004). For patients without rENE, those received salvage ND had better survival outcome (p < 0.001). By contrast, for patients with rENE, those received salvage RT/CCRT had better survival outcome (p < 0.001). ConclusionThe rENE is frequently present (78.79%) in OSCC patients with isolated nodal recurrence. Individualized treatment modalities based on the presence of rENE should be recommended to achieve better salvage outcomes.